NCMA: Nursing Conceptual Model
LECTURE 1: (PPT & LECTURE BASED)
_______________________________________________________________________________________________________
MA’AM ANNABELLE FLORES
1st SEMESTER | A.Y. 2022 – 2023
MARTHA ROGERS: Science of Unitary Human
Beings
Background
• Martha E. Rogers was born in 1914 in Dallas,
Texas.
• She received her nursing diploma from the
Knoxville General Hospital School of Nursing in
1936, then earned her Public Health Nursing
degree from George Peabody College in
Tennessee in 1937.
• Her Master’s degree was from Teachers College
at Columbia University in 1945, and her
Doctorate in Nursing was earned at from Johns
Hopkins University in Baltimore in 1954. Rogers
died on March 13, 1994.
• Rogers worked as a professor at New York
University’s School of Nursing.
• She was also a Fellow for the American
Academy of Nursing.
• Her publications include:
Theoretical Basis of Nursing (1970)
Nursing Science and Art: A
Prospective (1988)
Nursing: Science of Unitary
Irreducible,
Human Beings Update (1990)
Vision of Space Based Nursing (1990)
Homodynamic principles
Resonance is an arrangement for human and
environment that undergo transformation.
Helicy is the nature of change is unpredictable,
continuous and innovative.
Integrality is the energy fields of human and
environment in a continuous mutual process.
Nursing Metaparadigm
1. The life process of the unitary human being is
one of wholeness and continuity as well as
dynamic and creative change.
2. Environment defines as irreducible pan
dimensional energy field identified by pattern
and manifesting characteristics different from
those of the parts
3. Health symbolize wellness and the absence of
disease and major illness
4. Nursing is both art and science and the nurse is
a factor in healing environment
Implications of Rogers Theory
Nursing Practice
• Evaluative and diagnostic phase includes
determining the patients’ and their family’s well-
being status at the time
• Interventive how the nurse will go about
implementing nursing interventions for the
patient.
Education
• That students have individual personalities and
patterns to their work.
• They are all unitary human beings and should be
interacted with differently
• Culture, family, and experiences affect their
reasons and motives to become a nurse
• Beings focuses on “the integrality of person and
environment, the individual’s active participation
in change, and each person’s individual pattern
Research
• It was found that the theory applies to any
environment that contains human beings.
• Her theory focuses nursing interventions on the
patient well -being overall and not just their
disease state
• It encourages the use of guided imagery,
relaxation, therapeutic touch, and meditation
Analysis of the Theory
Clarity – It is difficult-to-understand principles, lack of
operational definitions, and inadequate tools for
measurement model has passed the test of time for the
development of nursing science as nursing matured as a
science
Simplicity - when the model is examined in total
perspective, some still classify it as complex. With its
continued use in practice, research, and education,
nurses will come to appreciate the model’s elegant
simplicity
Generality - Rogers’ conceptual model is abstract and
therefore generalizable and powerful. It is broad in
scope, providing a framework for the development of
nursing knowledge through the generation of grand and
middle-range theories
Importance- Rogers’ science has the fundamental intent
of understanding human evolution and its potential for
human betterment. The science “coordinates a universe
of open systems to identify the focus of a new paradigm
and initiate nursing’s identity as a science”
1
 NCMA: Nursing Conceptual Model
LECTURE 1: (PPT & LECTURE BASED)
_______________________________________________________________________________________________________
MA’AM ANNABELLE FLORES
1st SEMESTER | A.Y. 2022 – 2023
Application to Nursing
Mary is a 53-year-old woman who is in end stage
leukemia. She has had two failed bone marrow
transplants and three rounds of chemotherapy. She is
moving into hospice home care, and the family and Mary
become your client. Mary is the mother of four children:
25, 23, 20, and 17. One child lives at home. Pattern
appraisal includes: Mary—frail, quiet, almost translucent
in appearance, resting comfortably in hospital bed in
living room, nasal O2 in place Tom—husband, quiet,
pacing Home—clean, orderly, many personal articles,
large window facing north and looking into the yard.
Noise level low. Dog sleeping on floor
Analysis
1. End of life is a process of merging of the past,
present, and future
2. Nursing care for Mary offers the opportunity to
incorporate a variety of patterning
3. As Mary nears and prepares for the end of her
life, many patterning concerns must be
addressed for peaceful closure to her life and
the change to another energy form
4. The visible rhythmical pattern is a manifestation
of peace (Mary) and a human environmental
manifestation of anxiety in husband
5. The unknown and preparation for loss is the
focus. The pattern appraisal is ongoing
6. Harmony is noted in her relationship with her
husband and family and with her sense of how
she has progressed through this disease
process.
DOROTEA OREM: Self-Care Deficit
Background
• Dorothea E. Orem (1914-2007), one of the prime
US theorists born in Baltimore, Maryland
• Obtain her basic diploma in nursing at School of
Nursing Washington, BSN (1939) and MSN in
1945 from Catholic University of America, and
Doctorate degrees (honorary Doctorates
awarded from different Universities).
• She began her nursing career at Providence
Hospital School of Nursing in Washington, DC,
where she received a diploma of nursing in the
early 1930s.
• She published her theory in 1959 for the first
time and revised in 1971, 1983, 1987, and 2001.
Her contributions enabled her to achieve
Excellency from prominent societies like Sigma
Theta Tau International Society, the National
League for Nursing, and the American Academy
of Nursing.
Orem Philosophy
“Nursing is the ability to care for another human
being, most importantly when they are unable to
care for themselves. The ultimate goal is
achieving an optimal level of health and
wellness for our patients”. Orem (1971)
Concepts of Orem’s Model
1. The Self-Care Deficit Theory developed as a
result of working toward her goal of improving
the quality of nursing in general hospitals in her
state.
2. The model interrelates concepts in such a way
as to create a different way of looking at a
particular phenomenon.
3. The theory is relatively simple, but generalizable
to apply to a wide variety of patients.
4. It can be used by nurses to guide and improve
practice, but it must be consistent with other
validated theories, laws and principles
Concepts and Definition
The self-care deficit nursing theory is a general theory
composed of the following four related theories
• The theory of self-care, which describes why
and how people care for themselves
• The theory of dependent-care, which explains
how family members and/or friends provide
dependent-care for a person who is socially
dependent
• The theory of self-care deficit, which describes
and explains why people can be helped through
nursing
• The theory of nursing systems, which
describes and explains relationships that must
be brought about and maintained for nursing to
be produced
Theory of Self Care
“Self –care comprises the practice of activities that
maturing and mature persons initiate and perform, within
time frames, on their own behalf in the interest of
maintaining life, healthful functioning, continuing
personal development and well-being through meeting
known requisites for functional and developmental
regulations”.
The Theory of Self-Care has three components:
o Universal self-care needs,
o Developmental self-care needs and;
o Health deviation.
3 Components of Self Care
1. Universal Self Care Needs Air, food, water,
elimination/excretion, activity & rest,
solitude/social interaction, functioning/well-being,
normalcy
2. Developmental Self Care Requisites: more
specific to the process of growth and
development and are influenced by what is
happening during the life cycle, It can be positive
or negative.
3. Health Deviation Self Care Requisites: When a
condition permanently or temporarily alters
structural, physiological or psychological function
2
 NCMA: Nursing Conceptual Model
LECTURE 1: (PPT & LECTURE BASED)
_______________________________________________________________________________________________________
MA’AM ANNABELLE FLORES
1st SEMESTER | A.Y. 2022 – 2023
Self-Care
1. Self-Care Agent provides the foundation for
understanding the action requirements and
action limitations of persons who may benefit
from nursing.
2. Theory of dependent care “explains how the
self-care system is modified when it is directed
toward a person who is socially dependent and
needs assistance in meeting his or her self-care
requisites”
3. Therapeutic self-care demand is the totality of
self-care actions to be performed for some
duration in order to meet self-care requisites by
using valid methods and related sets of
operations and actions.
Basic Conditioning Factors
The basic conditioning factors affects the value of the
therapeutic use of therapeutic self-care demands
• Age
• Gender
• Developmental state: psycho social, cognitive,
psycho sexual
• Health state; disability due to health condition
• Pattern of living: extended family, nuclear family
• Healthcare system: home care, hospital, LTCU
• Socio cultural orientation – about education
• External environmental factors: living in rural
area, items used for ADL
Theory of Dependent Care
Dependent care refers to the care that is provided to a
person who, because of age or related factors, is unable
to perform the self-care needed to maintain life, healthful
functioning, continuing personal development, and well-
being.
Dependent-Care Demand
Summation of care measures at a specific point in time
or over a duration of time for meeting the dependent’s
therapeutic self-care demand when his or her self-care
agency is not adequate or operational.
Self-Care Agency
The self-care agency is a complex acquired ability of
mature and maturing persons to know and meet their
continuing requirements for deliberate, purposive action
to regulate their own human functioning and
development
Dependent-Care Agency
Refers to the acquired ability of a person to know and
meet the therapeutic self-care demand of the dependent
person and/or regulate the development and exercise of
the dependent’s self-care agency
Theory of Self-Care Deficit
1. A self-care deficit occurs when an individual
cannot carry out self-care requisites.
2. Orem identifies method of helping:
Acting for and doing for others
Guiding and directing
Providing Physical and Psychological support
Environment of promoting personal development
Teaching
Examples of self-care requisites are:
Wound care
Activities of Daily Living
Bowel program
Glucose monitoring
Theory of Nursing Systems
1. Wholly compensatory support- patient is
unable to complete any self-care independently;
nursing compensates for patient’s inability to
perform self-care.
2. Partial compensatory support- patient is able
to perform self-care tasks with partial or no
assistance from nursing.
3. Supportive/educative compensatory– patient
able to perform tasks independently. Nursing
provides ongoing education and support.
4.
Four major Concepts of Orem
Health is a state characterized by soundness or
wholeness of developed human structures and of bodily
and mental functioning.
People is viewed biologically, symbolically and socially
but still as a whole person. This person is considered to
be able to provide self-care
Nursing is how a healthcare professional develops a
plan of care to meet the patient’s self-care needs
Environment is the physical, chemical, biologic and
social factors that make up who a person is.
Significance of the Theory
Nursing Practice – has achieved a significant level of
acceptance by the international nursing community, as
evidenced by the magnitude of published material and
presentations at the International Orem Society World
Congresses
Education – The SCDNT was introduced as the basic
structure for nursing management in German hospital
DRG (diagnosis-related group) implementation. The
movement toward SCDNT-based nursing management.
The influence of Orem’s SCDNT has continued at the
international level through the translation of Nursing
Concepts of Practice into several languages.
Research – using the SCDNT or components, Biggs
(2008) found more than 800 references. Berbiglia
identified selected practice settings and SCDNT
conceptual foci from a review of more than 3 decades of
use of the SCDNT in practice and research and
publicized selected international SCDNT practice models
for the twenty-first century
3
 NCMA: Nursing Conceptual Model
LECTURE 1: (PPT & LECTURE BASED)
_______________________________________________________________________________________________________
MA’AM ANNABELLE FLORES
1st SEMESTER | A.Y. 2022 – 2023

Analysis of the Theory Kings Open System Framework

1. Clarity - Orem defined the term and elaborated 1. Nursing Focus is the care of human being
the substantive structure of the concept in a way 2. Nursing Goal is the health of the individual and
that is unique while also congruent with other health care for the group
interpretations. 3. Human Beings are open system in constant
2. Simplicity - Orem’s theory is expressed in a interaction with the environment
limited number of terms. These terms are
defined and used consistently in the expression Interacting systems in the Theory of Goal Attainment
of the theory. Orem’s general theory, the
SCDNT, comprises the following four constituent Personal System
theories: self-care, dependent-care, self-care 1. Perception
deficit, and nursing systems 2. Self
3. Generality - As a general theory, it serves 3. Growth and Development
nurses engaged in nursing practice, in 4. Body Image
development and validation of nursing 5. Time
knowledge, and in teaching and learning nursing 6. Space
4. Accessibility - As a general theory, the SCDNT
provides a descriptive explanation of why Interpersonal system
persons require nursing and what processes are • How the nurse interrelates with a co-worker or
needed for the production of required nursing patient, particularly in a nurse-patient
care. relationship
The SCDNT differentiates the focus of nursing • Interaction
from other disciplines. Although other disciplines • Communication
find the theory of self-care helpful and contribute • Transaction
to its development, the theory of nursing • Role
systems provides a unique focus for nursing • Stress

Application to Nursing Social system

Mr. Shoaib is a 62 years old male patient admitted to a • An organized system of social role, behavior and
medical ward. He has right ischemic Cerebro Vascular practices
Accident (CVA) and a resultant left sided body paralysis. • Organization
He has no sensations or movement in the left side of the • Authority
body. He has lost his gag reflux and is unable to swallow • Power
food. A nasogastric (N/G) tube is placed for providing • Status
him nutrition. Mr. Shoaib is not able to change his • Decision Making
position and is dependent on care givers for changing
his position. He is also not able to carry out his routine
daily life activities. His family is worried whether he
would be able to regain control of his life or not. They are
also worried whether they would be able to provide him
the care he needs when he is discharged from hospital

Apply the case utilizing

1. Universal Self care requisite
2. Health deviant self care
3. Development of self care requisite

IMOGENE KING: Goal Attainment Theory

Background
• Theorist : Imogene King - born in 1923.
• Bachelor in science of nursing from St. Louis
University in 1948
• Master of science in nursing from St. Louis
University in 1957
• Doctorate from Teacher’s college, Columbia
University.
• Theory describes a dynamic, interpersonal
relationship in which a person grows and
develops to attain certain life goals.
• Factors which affects the attainment of goal are:
roles, stress, space & time
Assumptions
1. Basic Assumptions of goal attainment theory is
that the nurse and patient communicate
information, set mutual goal act to achieve these
goals it is the basic assumption of Nursing
Process
2. Each human being perceives the world as a total
person in making transaction with individual and
things in the environment

4
 NCMA: Nursing Conceptual Model
LECTURE 1: (PPT & LECTURE BASED)
_______________________________________________________________________________________________________
MA’AM ANNABELLE FLORES
1st SEMESTER | A.Y. 2022 – 2023
Nurse Patient Transaction Model
1. Action is a means of behavior or activities that
are towards the accomplishments of certain act.
It is both physical and mental.
2. Reaction is a form of reacting or a response to a
certain stimuli.
3. Interaction is any situation wherein the nurse
relates and deals with a clientele or patient.
4. Transaction is a unique observable in which
human being communicate with the environment
Metaparadigm
 Person existing in an open system who makes
choices and select alternative action
 Health as continuous adjustment to stress in the
internal and external environment
 Environment as the process of balance
involving internal ad external interactions inside
the social system
 Nursing is an observable behavior found in the
health care systems in society”. The goal of
nursing “is to help individuals maintain their
health so they can function in their roles”
Significance
Nursing Practice
• Individualized the plans of care while
encouraging active participation from clients
• The profession of nursing function through
individuals and groups within the environment
Education
• It is used in curriculum design in nursing
programs
• It provides a systematic means of viewing
nursing as profession, an organize body of
knowledge and clarifying nursing as discipline
Research
• It is design and conducted to implement this
system in hospital, ambulatory, community and
home care nursing
Education
• It is used in curriculum design in nursing
programs
• It provides a systematic means of viewing
nursing as profession, an organize body of
knowledge and clarifying nursing as discipline
Research
• It is design and conducted to implement this
system in hospital, ambulatory, community and
home care nursing
Analysis of the theory
1. Clarity- Theory of Goal Attainment is the ease
with which it can be understood by nurses.
Concepts are concretely defined and illustrated.
2. Simplicity- King’s definitions are clear and are
conceptually derived from research literature.
3. Generality – It has been criticized for having
limited application in areas of nursing in which
patients are unable to interact competently with
the nurse.
4. Accessibility - A descriptive study was
conducted to identify the characteristics of
transaction and whether nurses made
transactions with patients
5. Importance- middle-range Theory of Goal
Attainment focused on all aspects of the nursing
process: assessment, planning, implementation,
and evaluation. The body of literature clearly
establishes King’s work as important for
knowledge building in the discipline of nursing.
Application to Nursing
1. Communication between nurse and patient is
the cornerstone of the interpersonal system and
the most important prerequisite for transaction to
occur. It can be established both verbally and
nonverbally.
2. A middle-aged female patient referred to the
emergency room with weakness and feebleness.
The attending physician gave the diagnosis of
acute pulmonary edema. Emergency staffs
needed to start invasive interventions to manage
her acute condition. However, they failed to
understand her conditions and did not provide
her with adequate treatment-related information.
She did not give consent for treatments and
treatments were not administered. This example
shows that nurses and physicians need to give
high priority to the establishment of effective
communication with patients to help them make
wiser decisions to retain their own health as their
main goal. Moreover, they need to allow patients
articulate their perceptions of their illnesses,
personal illness-related experiences, and the
level of their stress. It is only in this way that
nurse and patient can help each other and
create a favorable environment for decision-
making.. Consequently, the goal of health is
attained when both sides of relationship properly
interact with each other and collaboratively work
together to attain their goals.